Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 59301 | CA |
Y | 1223D0004X | Dentist Anesthesiologist | 1617 | CA |
NPI | 1902127558 |
---|---|
Provider Name | Dr. Stuart Seheult |
First Address | Yucaipa, CA 92399-9407 |
Second Address | Yucaipa, CA 92399-9407 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2010 |
Last Update Date | 07/05/2016 |